15 FEB 2024

The Oral Health Foundation is supporting calls to improve global oral health, following the release of a new report.

'Time to Put Your Money Where Your Mouth Is: Addressing Inequalities in Oral Health’ looks at the need for a joined-up approach between policy, public health initiatives and clinical practice, to address the challenges facing oral health.

Published by the European Federation of Periodontology (EFP), in collaboration with Economist Impact, the report investigates the impact of gum disease and tooth decay, and the urgent need to address existing inequalities.

It shows oral health is largely excluded amongst other NCDs (e.g. mental disorders, cardiovascular diseases, diabetes, cancers and chronic respiratory diseases) and does not recognise oral disease as a risk factor.

This is despite a recent World Health Organisation (WHO) resolution urging oral care integration into wider healthcare.

Dr Nigel Carter, chief executive of the Oral Health Foundation, was part of the editorial team for the report and believes the shift in understanding oral diseases as preventable non-communicable diseases (NCDs) is crucial.

Dr Carter says: “It's disheartening that mainstream NCD discussions often overlook oral health despite the 2021 WHO Resolution. Neglecting the impact of oral health and its shared risk factors with other NCDs is a missed opportunity for comprehensive healthcare planning.

"Urgent action is needed to boost public awareness on the relationship between oral health and overall well-being. A vital step for a healthier society."

The report, which was supported by Haleon, also identifies several barriers towards implementing effective preventive measures. These included a lack of political will for water fluoridation, varying sugar tax success, and pandemic-related disruptions to school-based programmes.

"Preventive measures are crucial for reducing oral diseases, yet formidable barriers persist,” adds Dr Carter.

"The urgent need for community support is clear. The public, clinicians, and campaigners must intensify pressure on policymakers to overcome challenges like political reluctance, geographical complexities, and industry opposition.

"Emphasising community water fluoridation, sugar taxes, and robust education programmes is vital for a global shift towards improved oral health.”

Presented on Tuesday by the EFP in Brussels, the report also expressed concerns that clinical care for tooth decay remains largely focused on a “repair approach”.

Analysis found that decades of oral care focus has been placed on reactive, not preventive, measures. It also revealed limited preventive training and inadequate incentives for health professionals.

Dr Carter says: "The core issue in the UK lies in an unfit dental contract solely focused on UDAs, sidelining preventive care. Urgent reforms are essential, emphasising the need to expand the oral health workforce and implement robust payment incentives that prioritise and reward preventive measures."

The report also laid bare the economic burden of oral disease. Direct global treatment costs due to the three most common oral conditions (tooth decay, severe gum disease, and severe tooth loss) were estimated at £285 billion yearly, representing around 5% of worldwide health expenditure.

The indirect costs due to loss of productivity was estimated at roughly £150 billion.

Dr Paula Vassallo, President of the European Association of Dental Public Health, looks at the bigger picture when it comes to the economic burden and potential opportunity to improve population health and save finite resources for the health system.

Dr Vassallo says: “Oral health is like the canary in the coal mine. If an individual has oral health problems, what is going to be the cost of all the additional factors? Not only the economic burden in terms of absenteeism and presenteeism from work, but also other NCDs.”

The UK was given the unwanted position of being the country with the highest per-person cost for treating tooth decay – amounting to £18,000 per-person.

This cost jumped to around £23,000 for more deprived people, who face disproportionate economic burden due to limited treatment options.

Economist Impact modelled the cost savings associated with preventive strategies. They found that implementing preventive interventions could reduce rates of tooth decay by as much as 30% while substantially cutting costs.

“Targeted preventive management is crucial across the entire population, but it will undoubtedly have a greater impact for addressing socioeconomic disparities,” adds Dr Carter.

"There must be a firm commitment from government to level-up oral health and narrow the gap between the highest and lowest socioeconomic groups.”

Read the full report ‘Time to Put Your Money Where Your Mouth Is: Addressing Inequalities in Oral Health’.